Healthcare Provider Details

I. General information

NPI: 1083953095
Provider Name (Legal Business Name): STEPPING STONE SUPPORT CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2013
Last Update Date: 04/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9032 W KEN CARYL AVE # A1-A3
LITTLETON CO
80128-9330
US

IV. Provider business mailing address

9032 W KEN CARYL AVE # A1-A3
LITTLETON CO
80128-9330
US

V. Phone/Fax

Practice location:
  • Phone: 720-839-4626
  • Fax:
Mailing address:
  • Phone: 720-839-4626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: BRYN MARIE BALDASSARI
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 720-839-4626